Individual provider Active NPI

Jennifer Lee Gustafson, NP

  • Acute Care Nurse Practitioner
  • Oroville, CA
National Provider Identifier
1639475254
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NP19069 Issued in CA
Practice address
2767 Olive Hwy
Oroville, CA 95966-6118
Phone
(530) 533-8500
Fax
(530) 538-3277
NPI assigned
Jan 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP19069 CA Primary

Addresses

Primary practice location

2767 Olive Hwy
Oroville, CA 95966-6118

Mailing address

2767 Olive Hwy
Oroville, CA 95966-6118
Phone (530) 533-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110902000050 CA Practitioner - Nurse Practitioner 7517137334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orohealth Corporation a Non Profit Healthcare SystemGroup PAC ID 4082501192, 126 clinicians

Practice addresses (Care Compare)

2767 Olice Hwy
Oroville, CA 95966-6118

2767 Olive Hwy
Oroville, CA 95966-6118

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.23 of 100Reported as group
Quality
36.36
Promoting interoperability
100
Improvement activities
40
Cost
71.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19069CAMDAcupuncturist
NP19069CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orohealth Corporation a Non Profit Healthcare System CurrentSince Dec 13, 2016 Accepting new patients

Locations

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296172800000",
    "number": "1639475254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500",
            "fax_number": "530-538-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500",
            "fax_number": "530-538-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "NP19069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.